Microsurgical vascular bypass in the setting of pediatric limb length discrepancy

Jason L Schwarz; Rolla Zarifa; Lawrence J Gottlieb; Christopher M Sullivan; Grace Z Mak; Christopher L Skelly

doi:10.1016/j.jvscit.2020.08.022

Microsurgical vascular bypass in the setting of pediatric limb length discrepancy

J Vasc Surg Cases Innov Tech. 2020 Sep 2;6(4):641-645. doi: 10.1016/j.jvscit.2020.08.022. eCollection 2020 Dec.

Authors

Jason L Schwarz¹, Rolla Zarifa², Lawrence J Gottlieb³, Christopher M Sullivan⁴, Grace Z Mak⁵, Christopher L Skelly²

Affiliations

¹ Section of General Surgery, Department of Surgery, University of Chicago Medicine, Chicago, Ill.
² Section of Vascular Surgery, Department of Surgery, University of Chicago Medicine, Chicago, Ill.
³ Section of Plastic and Reconstructive Surgery, Department of Surgery, University of Chicago Medicine, Chicago, Ill.
⁴ Department of Orthopedic Surgery, University of Chicago Medicine, Chicago, Ill.
⁵ Section of Pediatric Surgery, Department of Surgery, University of Chicago Medicine, Chicago, Ill.

Abstract

Management of pediatric iatrogenic arterial occlusions can be challenging clinically, leading to chronic complications such as claudication and limb length discrepancy. We report the case of a 6-month-old female patient who had experienced iatrogenic right external iliac and common femoral arterial occlusion. At the age of 8 years, she had developed claudication and a limb length discrepancy of 3.2 cm. She underwent common iliac artery to superficial femoral artery and profunda artery bypass via a branched autologous reverse great saphenous vein using microsurgical techniques for the distal anastomoses. In the present report, we have focused on the musculoskeletal improvements, benefits of microsurgery in pediatric vessels, and maximization of epiphyseal perfusion.

Keywords: Bypass graft; Limb ischemia; Limb length discrepancy; Microsurgery; Pediatric; Vascular trauma.

Publication types

Case Reports